Before dawn on Tuesday morning, October 30, in the midst of flooding and damaging winds from Hurricane Sandy, New York University's (NYU’s) most fragile patients, premature infants, were carried down 9 flights of stairs in the dark and transported to hospitals on dry ground.1 Although the infants arrived safely, the mid-storm evacuation of these critically ill patients was concerning. A safer daylight transfer before flooding overwhelmed southern Manhattan would have been preferable. The Veterans Affairs (VA) New York Harbor hospital evacuated patients before the storm.2 Bellevue, New York's flagship public hospital, evacuated patients in the immediate aftermath of the storm when the backup power supply failed.3,4 These neighboring hospitals each made different decisions about when to evacuate. Across the New York City metro region, many hospitals, nursing homes, and assisted living facilities were evacuated, most of them after the storm hit, making this the central public health challenge of this calamitous event.